本篇個案報告是護理一位血液透析病患發生猛爆性肝衰竭（fulminant hepatic failure），接受分子吸附再循環系統（molecular absorbents recirculating system; MARS）治療的護理經驗。筆者在護理期間以Gordon十一項健康功能評估為指引，藉由觀察、會談、身體評估等方式收集資料，確立個案於住院期間有低效性呼吸型態、體液容積缺失、睡眠型態紊亂及無望感等護理問題。護理措施除了維持生命徵象的穩定外，並以持續性照護及主動關懷、溝通，與個案建立穩定的護病關係，提供個案正面的醫療訊息，助其減輕焦慮及無望感，並維持個案基本生理需求及滿足，加強自我問題解決能力及建立完善的支持系統，協助個案對疾病的調適以及於自我概念、角色功能、相互依賴的需求，最後護理重點放在使個案治療擁有正向態度和坦然面對未來生活的挑戰。

The purpose of this report was to analyze the nursing care experience of a patient with fulminant hepatic failure had received molecular absorbents recirculating system (MARS) treatment in his hemodialysis. Comprehensive nursing assessments were performed by the eleven criteria of Gordon model during the nursing care. The health problems of this patient are: ineffective breathing pattern, fluid volume deficit, disturbance of sleep pattern, and hopelessness. The focuses of nursing care are not only maintenance of vital signs but also the provsion positive medical signals, the reduction of anxiety and hopelessness, the increusion of the ability to resolve self questions and establishment of perfect support system. Finally, the focus of caring is supporting the patient to have right attitudes for treatment and facing the challenges of future life.